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General NPI Number Information
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NPI Number | 1083918536
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Entity Type | Organization
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Legal Business Name | JAMES P. BRENT, DDS, PC
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Dates
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Enumeration Date | 12/27/2010
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 28487 STATE HIGHWAY W
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City | WARRENTON
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State | MO
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Zip | 63383
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Country | US
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Telephone | 636-456-4746
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Fax | 636-456-3943
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Provider Business Mailing Address
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Address Line | 28487 STATE HIGHWAY W
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City | WARRENTON
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State | MO
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Zip | 63383
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Country | US
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Telephone | 636-456-4746
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Fax | 636-456-3943
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES P BRENT
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Credential | DDS
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Telephone | 636-456-4746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13248
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License Number State | MO
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